CRF3B

Variable / Field Name	Section Header	Field Type	Field Label	Choices or Calculations
crf3b_version		radio	CRF3 Version Completed	1, Unversioned ; 2, 1.0 ; 3, 1.1 ; 4, 1.2 ; 5, 1.3 ; 6, 1.4 ; 7, 1.5 ; 8, 1.6 ; 9, 2.0
crf3b_date_consent		text	Date of consent
crf3b_ongoing_consent_done		yesno	Ongoing consent confirmed verbally?	1, Yes ; 0, No
crf3b_date_visit		text	Date of visit
crf3b_visit		radio	Type of this visit	1, 3 months visit ; 2, 12 months visit
crf3b_rest_spo2_done	Resting observations (If no corresponding clinical visit)	radio	a) Pulse Oximetry (SpO2)	1, Yes ; 0, No
crf3b_rest_hr_done		radio	b) Heart rate	1, Yes ; 0, No
crf3b_rest_bp_done		radio	c) Blood pressure	1, Yes ; 0, No
crf3b_rest_temp_done		radio	d) Temperature	1, Yes ; 0, No
crf3b_rest_height_done		radio	e) Height (cm)	1, Yes ; 0, No
crf3b_rest_weight_done		radio	f) Weight (kg)	1, Yes ; 0, No
crf3b_rest_spo2		text	a) Resting Pulse Oximetry (SpO2):
crf3b_rest_hr		text	b) Resting heart rate:
crf3b_rest_bp_sys		text	c) Resting blood pressure (systolic):
crf3b_rest_bp_dia		text	c) Resting blood pressure (diastolic):
crf3b_rest_temp		text	d) Temperature:
crf3b_rest_height		text	e) Height (cm):
crf3b_rest_weight		text	f) Weight (kg):
crf3b_base_ecg_done	Basic investigations (If no corresponding clinical visit)	radio	ECG	1, Completed ; 0, Not done
crf3b_ecg		radio	ECG result:	1, Sinus rhythm ; 2, Atrial fibrillation/flutter ; 3, ST segment/T wave changes ; 4, RBBB ; 5, LBBB
crf3b_base_ecg_hr		text	ECG heart rate:
crf3b_hcare_ehv	Healthcare utilisation	radio	Emergency hospital visit	1, Yes ; 0, No
crf3b_hcare_pacr		radio	Planned additional COVID-related review	1, Yes ; 0, No
crf3b_hcare_cgp		radio	Contacts with GP for a clinical review	1, Yes ; 0, No
crf3b_hcare_med		radio	Any changes in regular medication	1, Yes ; 0, No
crf3b_crfev_done		yesno	Have you completed Emergency Visit CRF for any unplanned emergency visits?	1, Yes ; 0, No
crf3b_crf4_done		yesno	Have you completed CRF4 for any additional planned COVID-related clinical visits?	1, Yes ; 0, No
crf3b_medlog_done		yesno	Have you completed or updated medication log?	1, Yes ; 0, No
crf3b_eq5d_done		yesno	Have you completed a EQ-5D-5L form (Pre-COVID)?	1, Yes ; 0, No
crf3b_mrc_done		yesno	Have you completed a MRC dyspnoea scale form (Before COVID)?	1, Yes ; 0, No
crf3b_social_history_done		yesno	Have you completed a Social History form?	1, Yes ; 0, No
crf3b_new_prob		yesno	Are you experiencing any new problems that we haven't mentioned?	1, Yes ; 0, No
crf3b_new_prob_detail		notes	Please provide details for these new problems
crf3b_info_dis		notes	What information would have been helpful to receive at discharge?
crf3b_spost_livewell	Signposting	radio	https://www.nhs.uk/live-well/	1, Yes ; 0, No ; 2, Unsure
crf3b_spost_iapt		radio	Improving Access to Psychological Therapies (IAPT)	1, Yes ; 0, No ; 2, Unsure
crf3b_spost_shyg		radio	Sleep hygiene	1, Yes ; 0, No ; 2, Unsure
crf3b_spost_mental		radio	Mental wellbeing - Daylight app/weblink	1, Yes ; 0, No ; 2, Unsure
crf3b_spost_drinkfree		radio	Alcohol - 'Drink free days'	1, Yes ; 0, No ; 2, Unsure
crf3b_spost_phyinac		radio	Physical inactivity - 'couch to 5K' or 'Active 10'	1, Yes ; 0, No ; 2, Unsure
crf3b_spost_smkadv		radio	Smoking Advice https://www.nhs.uk/live-well/quit-smoking/	1, Yes ; 0, No ; 2, Unsure
crf3b_spost_smkref		radio	Smoking cessation referral	1, Yes ; 0, No ; 2, Unsure
crf3b_spost_smkapp		radio	'Smoke free' app	1, Yes ; 0, No ; 2, Unsure
crf3b_spost_wmgmt		radio	Weight management: http://www.nhs.uk/live-well/healthyweight/start-the-nhs-weight-loss-plan/	1, Yes ; 0, No ; 2, Unsure
crf3b_spost_heat		radio	Healthy eating:	1, Yes ; 0, No ; 2, Unsure
crf3b_inv_assess	Investigator completed assessments	checkbox	Investigator completed assessments	1, Montreal Cognitive Assessment (MoCA) ; 2, Clinical Frailty Scale ; 3, Fried Frailty assessment
crf3b_assess_moca		yesno	1. Have you completed a MoCA form?	1, Yes ; 0, No
crf3b_assess_cfs		yesno	2. Have you completed a Rockwood Clinical Frailty Scale form?	1, Yes ; 0, No
crf3b_truecolours_check	Questionnaires	yesno	Is the participant completing questionnaires using True Colours?	1, Yes ; 0, No
crf3b_quests		checkbox	Questionnaires	12, Pre-COVID Patient Symptom Questionnaire (Only to be completed once during study) ; 13, Patient Symptom Questionnaire ; 1, MRC dyspnoea scale ; 2, EQ-5D-5L ; 3, Generalised Anxiety Disorder Assessment (GAD-7) ; 4, Patient Health Questionnaire (PHQ-9) ; 5, Sarcopenia screen (SARC-F) ; 6, General Practice Physical Activity Questionnaire (GPPAQ) ; 7, Dyspnoea-12 ; 8, Fatigue (FACIT) ; 9, Brief Pain Inventory (BPI) ; 10, Post-Traumatic Stress Disorder (PTSD) checklist (PCL-5) ; 11, Nottingham extended activity of daily living (NEADL)
crf3b_quest_pre_psq		yesno	1. Have you completed a Pre-COVID Patient Symptom Questionnaire form?	1, Yes ; 0, No
crf3b_quest_psq		yesno	2. Have you completed a Patient Symptom Questionnaire form?	1, Yes ; 0, No
crf3b_quest_mrc		yesno	3. Have you completed a MRC dyspnoea scale form (Since COVID)?	1, Yes ; 0, No
crf3b_quest_eq5d5l		yesno	4. Have you completed a EQ-5D-5L form (Current visit)?	1, Yes ; 0, No
crf3b_quest_gad7		yesno	5. Have you completed a GAD-7 form?	1, Yes ; 0, No
crf3b_quest_phq9		yesno	6. Have you completed a PHQ-9 form?	1, Yes ; 0, No
crf3b_quest_sarcf		yesno	7. Have you completed a SARC-F form?	1, Yes ; 0, No
crf3b_quest_gppaq		yesno	8. Have you completed a GPPAQ form?	1, Yes ; 0, No
crf3b_quest_dys12		yesno	9. Have you completed a Dyspnoea-12 form?	1, Yes ; 0, No
crf3b_quest_facit		yesno	10. Have you completed a FACIT form?	1, Yes ; 0, No
crf3b_quest_bpi		yesno	11. Have you completed a BPI form?	1, Yes ; 0, No
crf3b_quest_pcl5		yesno	12. Have you completed a PCL-5 form?	1, Yes ; 0, No
crf3b_quest_neadl		yesno	13. Have you completed a NEADL form?	1, Yes ; 0, No
crf3b_fried_date	Fried's Frailty Assessment Questions	text	Date completed
crf3b_fried_shrink		yesno	1. Shrinking: In the last year, has the patient lost more than 10lb (4.5 kilograms) unintentionally?	1, Yes ; 0, No
crf3b_fried_energy		yesno	2. Exhaustion - Q1: Do they feel full of energy?	1, Yes ; 0, No
crf3b_fried_rest_day		radio	2. Exhaustion - Q2: During the last 4 weeks how often have they rested in bed during the day?	1, Every day ; 2, Every week ; 3, Once ; 4, Not at all
crf3b_t2_core	Tier 2 Core Tests	yesno	Have you completed a Tier 2 Core Tests Checklist?	1, Yes ; 0, No
crf3b_t2_research	Tier 2 Biological Research Samples	yesno	Have you completed a Tier 2 Biological Research Samples Checklist?	1, Yes ; 0, No
crf3b_pft	Pulmonary Function Tests (PFTs)	yesno	Have you completed Pulmonary function tests (PFTs) forms?	1, Yes ; 0, No
crf3b_qrisk3	QRISK®3	yesno	Have you completed a QRISK®3 form?	1, Yes ; 0, No
cr3b_waist_done		yesno	Waist circumference measurement: Completed	1, Yes ; 0, No
cr3b_waist_result		text	Waist circumference measurement: Result
crf3b_rehab_q1	Post-discharge Rehabilitation Programme	radio	1. Has the patient been referred to a rehabilitation programme after their hospital admission with COVID-19?	1, Yes ; 0, No ; 2, Not sure
crf3b_rehab_q2		radio	2. Did they attend any rehabilitation session(s)?	1, Yes ; 0, No ; 2, Not sure
crf3b_rehab_q3		radio	3. What was the nature of the session(s)?	1, Face-to-face ; 2, Virtual/remote ; 3, Both
crf3b_rehab_q4_yn		yesno	4. Is the total number of sessions attended by the patient so far known?	1, Yes ; 0, No
crf3b_rehab_q4		text	4. Total number of sessions attended by the patient so far
crf3b_rehab_q5		radio	5. Has the patient completed the programme & attended the discharge assessment?	1, Yes ; 0, No ; 2, Not sure
crf3b_rehab_q6		radio	6. Did they find the programme helpful?	1, Yes ; 0, No ; 2, Not sure
crf3b_psych_q1	Post-discharge Psychology Services Review	radio	1. Has the patient been referred to any psychology service after their hospital admission with COVID-19?	1, Yes ; 0, No ; 2, Not sure
crf3b_psych_q2		checkbox	2. Please select all that apply.	1, Post ICU psychology service ; 2, Psychiatric liaison service ; 3, Improving Access to Psychological Therapies (IAPT) ; 4, Acute Hospital Clinical Health Psychology service ; 5, Community Mental Health Team (adult) ; 6, Community Mental Health Team (older adult) ; 7, Psychological Therapies service for serious mental illness (SMI) ; 8, Mental health Crisis Resolution and Home Treatment service ; 9, In patient mental health service ; 10, Counselling services (Third sector or primary care based) ; 11, Private providers of psychological therapy ; 12, Other ; 13, Not known
crf3b_psych_q2_other		notes	2. Other post-discharge psychology services - Please specify
crf3b_psych_q3		radio	3. What was the nature of the session(s)?	1, Face-to-face ; 2, Virtual/remote ; 3, Both
crf3b_psych_q4		radio	4. Did they find the service(s) helpful?	1, Yes ; 0, No ; 2, Not sure
crf3b_bodycom_bia	Body composition measurements (BIA and DXA)	radio	Have you completed a BIA form?	1, Yes ; 0, No
crf3b_bodycom_dxa		radio	Have you completed a DXA form?	1, Yes ; 0, No
crf3b_muscle_strength	Muscle Strength	yesno	Have you completed a muscle strength form?	1, Yes ; 0, No
crf3b_iswt_1	Incremental shuttle walk test (ISWT) Modified 15 level	radio	ISWT measurement 1	1, Yes ; 0, No
crf3b_iswt_2		radio	ISWT measurement 2	1, Yes ; 0, No
crf3b_sppb	Short Physical Performance Battery (SPPB)	yesno	Have you completed a short physical performance battery (SPPB)  form?	1, Yes ; 0, No
crf3b_amc_inform	Activity Monitor checklist	yesno	1. Has the participant been informed about the activity monitor?	1, Yes ; 0, No
crf3b_amc_happy		yesno	2. Is the participant happy to receive and wear the activity monitor?	1, Yes ; 0, No
crf3b_amc_location		radio	3. Wear location	1, Wrist ; 2, Upper Arm
crf3b_amc_strap		radio	4. Strap Type	1, Plastic ; 2, Velcro
crf3b_amc_notes		notes	5. Activity Monitor checklist - Notes
crf3b_future_studies	Future studies	yesno	Is the participant happy to be contacted about future studies?	1, Yes ; 0, No